Rosa Parks is described as a quiet woman who, because she was tired of giving in, refused to give up her seat on the bus and eventually set off a civil rights movement in the US. Likewise, if it weren’t for the frustration husband and wife Abhinav Girdhar and Shrutika Girdhar experienced with the health system in India, they wouldn’t have become social entrepreneurs in the first place.

“I would not have gotten into entrepreneurship if there was not a real problem to solve,” said Shrutika.
“I was quite okay with my life before. But because this is a real problem and we see that we can make a difference with this venture, if we can make it large, it can have real value to society.”

The problem Shrutika noticed is that governments in India have a hard time providing quality healthcare services in remote places. There are few doctors serving the 1.2 billion population and most doctors work in urban areas where the commercial returns are good. The government, noticing this, recruits semi-literate women in villages as health workers and gives them basic medical training. These health workers have now become the backbone of the public health system in rural India, but they are not sufficiently trained and the government struggles to provide cost-effective, quality training.

“My village has a population of 2,000. I’ve seen that only two health workers work there and they do not have even the basic knowledge,” said Shrutika.

“These villagers pretty much depend on these health workers and there are no alternatives. So what happens is that there is extreme neglect which leads to mortality,” said Abhinav. Treatable problems such as diarrhea or snake bites eventually lead to death.

Abhinav, who holds healthcare close to his heart because his parents worked in public health for three decades, left the private sector to start Bodhi Health Education with Shrutika, an engineer and technology expert. Together, they developed an easy-to-understand e-learning software delivered through computers, tablets, and phones to train health workers.

Since most health workers are semi-literate, they have a hard time understanding complex medical topics. Bodhi uses mainly videos and photos to make learning simple and engaging. The lessons are taught in India’s many regional languages, catering to communities across the country. On the platform, health workers learn about maternal and child care, immunization, common diseases such as malaria and tuberculosis, first aid, hygiene, and basic eye care. The tool also has an assessment feature that tracks how they are learning.

Bodhi is currently working with the Haryana state government to train 100 health workers as well as an eye care facility to train 100 vision assistants that go to rural areas to diagnose people for ailments such as cataract. One Bodhi tablet, which costs $65, can be shared among workers in a community, significantly reducing the costs of training.

Despite the benefits, governments are resisting to buy into the product as they cite concerns about damage to the hardware, theft, and it being a new, untested product. “For us, it’s kind of important to have satisfied customers and showcase the solution works to the other governments,” said Abhinav.

Shrutika explains that the main intention is to fill a gap left open by India’s governments, saying “they need the public-private partnerships or they need enterprises who can share the responsibility” of training health workers. But a conversation with Jungle Ventures’ Jayesh Parekh pushed them to think beyond governments and beyond India.

“We already started de-escalating the model from pure government and trying to serve the low-cost hospitals,” said Shrutika. “He was trying to point us in the direction that this solution is useful not only in India but can also be useful in other developing countries. I think we should start building our content in English.”

As a matter of fact, their solution is needed worldwide. The World Health Organization (WHO) reports a shortage of 7.2 million health workers today, and that number is expected to rise to 12.9 million by 2035. The largest shortages will be in Asia and sub-Saharan Africa. Carissa Etienne, WHO Regional Director for the Americas, says that the challenge in achieving universal health coverage is to make sure everyone has access to well-trained, culturally-sensitive, and competent health staff.

“We aim to train 60,000 health workers over the next three years. The bigger impact definitely will be the reduction in infant and maternal mortality rate. These are the indicators which are extremely poor in India. And these indicators can be definitely improved if you have bottom of the pyramid health workers trained,” said Abhinav.

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